Abstract 16602: Safety And Long-Term Outcome of Robotic-Guided Atrial Fibrillation Ablation: Results From the Worldwide Survey
Introductions: The Hansen Robotic system has been utilized in ablation procedures for atrial fibrillation (AF) aiming at minimizing X-ray exposure, improving catheter stability and possibly increasing success rate. However, because of the lack of tactile feedback and the rigidity of the robotic sheath, this approach could result in higher risk of complications. This worldwide survey reports a multicenter experience on the methodology, efficacy and safety of the Hansen system in AF ablations.
Methods: A questionnaire addressing questions on patient's demographics, procedural parameters, ablation success rate and safety information was sent to all centers where more than 50 AF ablation cases have been performed with the Hansen Robotic system. Data collected from the completed questionnaires were analyzed and compared with the data included in the updated worldwide survey on manual AF ablation.
Results: From June 2007 to December 2009, 1728 AF ablation cases were performed at 12 centers utilizing the Hansen robotic navigation technology for the access, mapping and ablation to/in the left atrium during the AF ablation, combining with either the NavX or CARTO mapping system. The fluoroscopy time was 38.04±24.31 (range 4.6-113) minutes and the procedure time was 193.61±42.01 (range 63-390) minutes. The overall complication rate was 4.7% which is similar to that of manual ablation cases (4.5%; p=0.64). Specifically, the incidence of the major complications, such as pericardial effusion/tamponade requiring intervention (1.16%), atrium-esophagus fistula (0.06%), stroke (0.12%), was comparable to those in the worldwide survey on manual ablation (1.31%, 0.04% and 0.23% respectively). The procedural success rate, defined as freedom from atrial tachyarrhythmia off anti-arrhythmic drug, was 67.1% after 15.03±2.94 months of follow-up which seems to be close to that (64.3%) reported in the worldwide survey on conventional AF ablation procedures. With a higher case volume (>100 cases) and better operator experience, the success rate increased while the complication rate decreased.
Conclusions: The Hansen robotic system can be used for AF ablation safely and it is associated with similar complication rate and efficacy to the conventional manual procedures.
- © 2011 by American Heart Association, Inc.